Lecture 1

Question 1

What is Hematology

What are the main components of blood?
What is hematocrit
What is the hematocrit value for males and what about females?
What is the least dense component of blood
What is the percentage of whole blood plasma?
What about the percentage of whole blood Buffy coat?
What does the Buffy coat contain?
What percentage of whole blood are erythrocytes

Answer 1

What is Hematology?”,”The study of blood and its components, including its formation and diseases.”
“What are the main components of blood?”,”Plasma and formed elements (erythrocytes (red blood cells), leukocytes (white blood cells), and platelets.)

“What is hematocrit?
the percentage of blood volume that is RBCs. Visualize a tube with plasma and RBCS settled at the bottom. The proportion or percentage of the tube that is filled with the RBCS is the hematocrit. It refers to the height of the tube filled with RBCS. In a hematocrit test, a sample of blood is placed into a thin, capillary tube and then centrifuged. During centrifugation, the components of blood separate based on their densities.
2. Measurement: After centrifugation, the red blood cells (RBCs) settle to the bottom of the tube, forming a packed layer. The height of this layer is then measured.

hematocrit is not merely against the volume within the tube itself but is interpreted as an indication of the percentage of red blood cells in the entire blood volume of the body.

What is it’s value in males?”,”47% ± 5%”
“What is the percentage of blood volume that is RBCs in females?”,”42% ± 5%”
“What is the least dense component of blood?”,”Plasma”
“What percentage of whole blood is plasma?”,”55%”
“What percentage of whole blood is the buffy coat?”,”<1%”. It is located between the plasma and the erythrocytes
“What does the buffy coat contain?”,”Leukocytes and platelets”
“What percentage of whole blood are erythrocytes?”,”45%”
Erythrocytes are the most dense part of whole blood

Question 2

State 11 components of plasma
What is the difference between plasma and serum and how are both obtained?
Which of the two have a longer shelf life?

Answer 2

Plasma contains water, salts, enzymes, antibodies, proteins (albumin,globulins,fibrinogen), coagulation factors (e.g fibronogen, Factor VIII, etc ), electrolytes, amino acids,nitrogenous waste,nutrients,gases,

Plasma has clotting factors. You obtain it by centrifuging blood with anticoagulant. It also contains fibrinogen. It is easy and quicker to separate from blood sample and is used for tests that require you to detect clotting factors. Is the main medium for excretory product transportation

Serum- liquid that remains after blood clots. That’s why it doesn’t have clotting factors. Cuz they’ve already been used to make the blood to clot. It also has water, proteins, minerals,etc
Can be obtained by centrifuging coagulated blood.
You won’t add anticoagulant.
Has a longer shelf life (about 10 years) cuz there aren’t any clotting factors.

Question 3

What is the ph of blood?
What’s the temperature of blood?(not temperature of body)
Blood constitutes what percentage of body weight?
What is the average blood volume for males?(in liters)
What is the average blood volume for females?(in liters)
Why do males have a higher blood volume than females

Answer 3

What are the physical characteristics of blood?”,”Sticky, opaque fluid, color ranges from scarlet to dark red, pH 7.35-7.45, temperature 38°C, ~8% of body weight.”

What is the average blood volume for females?”,”4-5 liters”
“What is the average blood volume for males?”,”5-6 liters

Males have more blood than females cuz they have larger muscle or body mass hence more blood vessels that have to perfuse the extra muscle mass or body mass.
Also,females lose blood every month when they menstruate so they’re blood is lower than males

Question 4

State 8 functions of blood (3 distributive,3 regulatory,2 protective)

Answer 4

1.Distribution of:
•O2 and nutrients to body cells
•Metabolic wastes to the lungs and kidneys for elimination
•Hormones from endocrine organs to target organs

Regulation of:
•Body temperature by absorbing and distributing heat-Blood comes closer to skin surface for heat to leave the body hence regulating body temperature
•Normal pH using buffers-Able to resist changes in ph that’s why it’s a very good buffer.
•Adequate fluid volume in the circulatory system

Protection against:
•Blood loss-
•Plasma proteins and platelets initiate clot formation

•Infection-
•Antibodies
•Complement proteins
•WBCs defend against foreign invaders

Blood produced immunoglobulins to fight infections
Has complement proteins to coat or make the foreign body look appetizing to be eaten or phagocytosed(this process is opsonization)

Question 5

How do you get blood from a person?

90% of plasma is comprised of what?
Which proteins are found in the plasma
State them in order of the most abundant

Here are three multiple-choice questions based on the provided percentages of blood plasma proteins:

1. What percentage of plasma proteins is represented by albumin?
   
   • A) 36%
   • B) 60%
   • C) 4%
   • D) 40%
2. Which of the following plasma proteins constitutes 4% of the total plasma proteins?
   
   • A) Albumin
   • B) Globulins
   • C) Fibrinogen
   • D) Enzymes
3. If the total plasma protein concentration is 100%, what percentage is represented by globulins?
   
   • A) 60%
   • B) 36%
   • C) 4%
   • D) 40%

Answer 5

Using syringe
Using vacutainer

90% water
•Proteins are mostly produced by the liver(mnemonic-Agcm. A is albumin and g is globulin so definitely the third and final is fibrinogen )

Here are three multiple-choice questions based on the provided percentages of blood plasma proteins:

1. What percentage of plasma proteins is represented by albumin?
   
   • A) 36%
   • B) 60%
   • C) 4%
   • D) 40%
   • Answer: B) 60%
2. Which of the following plasma proteins constitutes 4% of the total plasma proteins?
   
   • A) Albumin
   • B) Globulins
   • C) Fibrinogen
   • D) Enzymes
   • Answer: C) Fibrinogen
3. If the total plasma protein concentration is 100%, what percentage is represented by globulins?
   
   • A) 60%
   • B) 36%
   • C) 4%
   • D) 40%
   • Answer: B) 36%

•60% albumin
•36% globulins
•4% fibrinogen

Question 6

The following are components of plasma, state two examples each:
Nitrogenous by products of metabolism,nutrients,electrolytes,respiratory gases

Answer 6

Nitrogenous by-products of metabolism—lactic acid, urea, creatinine
•Nutrients—glucose, carbohydrates, amino acids
•Electrolytes—Na+, K+, Ca2+, Cl–, HCO3–
•Respiratory gases—O2 and CO2
•Hormones

Question 7

Which plasma protein is the main contributor of osmotic pressure? Where is it produced?
What is the function of globulins and where are they produced?
Which molecules do they usually bind to?

Choose the odd one out;
Albumin
Alpha globulin
Beta globulin
Gamma globulin
Fibrinogen

Why is gamma globulin different from both alpha and beta globulins?

Where is fibrinogen produced and what is its function?
What is the function of electrolytes in the plasma?
Name two molecules whose hormones are carried by plasma proteins?

Plasma proteins are the most
abundant of the general plasma solutes. True or false

Answer 7

Albumin is the main contributor of osmotic pressure and is produced by liver.
Globulins is also produced in liver and are transport proteins. They bind with lipids and fat soluble vitamins(ADEK)
Especially alpha and beta globulins.
Gamma globulin is different from alpha and beta globulins.
How?
Gamma globulins are not produced by the liver but are antibodies that are released by plasma cells.
Fibrinogen is also produced by liver and forms fibrin thread during blood clots.

Choose the odd one out;
Albumin
Alpha globulin
Beta globulin
Gamma globulin
Fibrinogen

Answer is gamma globulin

Electrolytes in the plasma Maintain plasma osmotic pressure and normal blood ph

Steroid and thyroid hormones are carried by plasma proteins.
Plasma proteins are the most Makes up 80% by weight of plasma volume.

Hormones aren’t produced by liver.
Plasma proteins aren’t taken up to be used as fuel for metabolic nutrients by the cells the way other plasma solutes such as carbs,amino acids,are taken up to be used as fuel.

Yes, you’re right that albumin also plays a role in transporting substances, but it primarily binds to water-insoluble molecules like fatty acids, hormones, bilirubin, and drugs, rather than specifically fat-soluble vitamins.

• Albumin: It mainly transports free fatty acids, hormones, and drugs in the bloodstream, and it helps maintain osmotic pressure.
• Globulins: While albumin is more of a general transporter, globulins (alpha and beta) are involved in transporting specific molecules like lipids and fat-soluble vitamins (A, D, E, K). These globulins have specialized binding roles that help transport these substances more efficiently.

So, both albumin and globulins contribute to transporting fat-soluble substances, but globulins have more specialized roles in carrying specific vitamins and lipids.

Question 8

Serum = plasma -fibrinogen
Which of the formed elements in blood are complete cells?
Which don’t have nuclei or organelles?
What are platelets
Where do blood cells originate from?

Answer 8

Only WBCs are complete cells
•RBCs have no nuclei or organelles
•Platelets are cell fragments
•Most formed elements survive in the bloodstream for only a few days
•Most blood cells originate in bone marrow and do not divide

most blood cells originate in the bone marrow through a process called hematopoiesis, but once they are fully matured and released into the bloodstream, they do not divide.

blood cells originate in the bone marrow, once they enter circulation, they do not divide, with the exception of lymphocytes that can proliferate during immune responses.

Question 9

Buffy coat in plasma is found between blood plasma and formed elements(RBS or erythrocytes,WBCS or leukocytes ,platelets or thrombocytes )

True or false?
How will you identify the formed elements in blood under microscope?

Answer 9

Formed elements:
RBCS are anucleated(don’t have nuclei) and are more numerous.
Central pallor which is found in the the RBCS shows the type of anemia an individual has during microscopy.
Monocytes has a kidney or B shape.
Lymphocytes don’t have kidney or B shape
Neutrophils have numerous lobes of nuclei. Hence, they are referred to as polymorphonuclear

Name and identify the types of formed elements:

Question 10

The absence of What structure in erythrocytes help them to easily change shape?
How do RBCS contribute to blood viscosity as a major contributor?

Answer 10

Erythrocytes can easy change shape or meander their way through blood vessels due to the fact that they don’t have a nucleus and they don’t have the typical cytoskeleton that cells usually have.

They contribute to blood viscosity(whether blood will appear thick or thin). So blood viscosity depends on the amount of RBCS you have in your blood

Question 11

What happens in polycythemia Vera concerning reduced oxygen and what medications are given for it?

Answer 11

Polycythemia Vera (excess production of red blood cells than normal)- symptom is blood is highly viscous. So blood movement becomes reduced due to how thick the blood has become. Hence less oxygen gets to target organs. Blood thinners are given to thin the blood so it can be less thick and move more freely.

Question 12

State five characteristics of RBCS

Answer 12

Biconcave discs, anucleate, essentially no organelles
•Filled with hemoglobin (Hb) for gas transport
•Contain the plasma membrane protein spectrin and other proteins this Provides flexibility to change shape as necessary
•Are the major factor contributing to blood viscosity

Question 13

How does the structural characteristics of RBCS contribute to blood transport

Answer 13

Structural characteristics contribute to gas transport
•Biconcave shape—huge surface area relative to volume
•>97% hemoglobin (not counting water)
•No mitochondria; ATP production is anaerobic; no O2 is used in generation of ATP
Since there is no Mitochondria in RBCS then it produces ATP without oxygen(anaerobically).
RBCS has a huge surface area to carry more hemoglobin.

Oxyhaemoglobin- when haemoglobin binds to oxygen.

Question 14

Hemoglobin binds irreversibly to oxygen true or false?
What is the structure of hemoglobin?
How many oxygen molecules can the iron atom in each gene bind to?
How many oxygen molecules can each haemoglobin carry?

Answer 14

False

RBCs are dedicated to respiratory gas transport
•Hemoglobin binds reversibly with oxygen

Hemoglobin structure
•Protein globin: two alpha and two beta chains
•Heme pigment bonded to each globin chain
•Iron atom in each heme can bind to one O2 molecule
•Each Hb molecule can transport four O2

Question 15

Hemoglobin binds irreversibly to oxygen true or false?
What is the structure of hemoglobin?
How many oxygen molecules can the iron atom in each gene bind to?
How many oxygen molecules can each haemoglobin carry?

Answer 15

False

RBCs are dedicated to respiratory gas transport
•Hemoglobin binds reversibly with oxygen

Hemoglobin structure
•Protein globin: two alpha and two beta chains
•Heme pigment bonded to each globin chain
•Iron atom in each heme can bind to one O2 molecule
•Each Hb molecule can transport four O2

Question 16

Oxygen loading into the lungs produces what type of haemoglobin? What is the color of this type of blood containing this type of haemoglobin?

CO2 loading into the tissues produces what type of haemoglobin?

Oxygen unloading into the tissues produces what type of haemoglobin? What is the color of this type of blood containing this type of haemoglobin?

Answer 16

O2 loading in the lungs
•Produces oxyhemoglobin (ruby red). In the lungs, oxygen binds to hemoglobin molecules in red blood cells, forming oxyhemoglobin.

•O2 unloading in the tissues
•Produces deoxyhemoglobin or reduced hemoglobin (dark red). As blood circulates to body tissues, oxyhemoglobin releases oxygen to cells where it is needed. This process converts oxyhemoglobin back to deoxyhemoglobin or reduced hemoglobin, which appears darker in color.

•CO2 loading in the tissues
•Produces carbaminohemoglobin (carries 20% of CO2 in the blood). In the tissues, carbon dioxide produced by cellular metabolism diffuses into red blood cells. Some of this carbon dioxide binds to hemoglobin, forming carbaminohemoglobin. This compound carries about 20% of carbon dioxide in the blood.

Question 17

What is haematopoiesis
Name four areas it can occur
In the embryonic yolk sac, exaplin how haematopoiesis occurs

Answer 17

Hematopoiesis (hemopoiesis): blood cell formation
•Occurs in red bone marrow of axial skeleton, girdles and proximal epiphyses of humerus and femur

Embryonic yolk sac: transient site of haemopoiesis → embryonic red cells. Starts around 3rd week of embroyonic develpment

Question 18

Which cells give rise to formed elements?
State two factors that push the above tote of cell toward the soecifc pathway of blood cell development
What is the difference between haematopoiesis and erytrhopoiesis

Answer 18

Hemocytoblasts (hematopoietic stem cells)
•Give rise to all formed elements
•Hormones and growth factors push the cell toward a specific pathway of blood cell development
•New blood cells enter blood sinusoids

Haematopoiesis is the formation of new blood cells while erythropoiesis is the formation of red blood cells specifically

Blasts- cells that form
Hemocytoblasts- so blood cells that are now forming.

Stem cells give rise to other cells.
The whole process occurs in red bone marrow
Haemeopoiesis is the formation of all cells or components in blood
Erythropoiesis is the formation of all red blood cells

Question 19

State the types of stem cells?
What type of stem cells are hemacytoblasts and why?

Answer 19

Types of stem cells:
Totipotent
Pluripotent
Multipotent

Hemocytoblasts are pluripotent and multipotent.
Why?

Sure, here’s a simplified explanation of the differences between totipotent, pluripotent, and multipotent stem cells, with examples:

• Potential: Can become any type of cell in the body and extra-embryonic tissues (like the placenta).
• Example: The fertilized egg (zygote).

• Potential: Can become almost any type of cell in the body, but not extra-embryonic tissues.
• Examples:
  
  • Embryonic stem cells (from early embryos).
  • Induced pluripotent stem cells (regular cells reprogrammed to be like embryonic stem cells).

• Potential: Can become multiple types of cells, but only within a related group.
• Examples:
  
  • Hematopoietic stem cells (can become different types of blood cells).
  • Mesenchymal stem cells (can become bone, cartilage, and fat cells).

• Totipotent: Any cell type + extra-embryonic tissues.
• Pluripotent: Any cell type, but no extra-embryonic tissues.
• Multipotent: Limited to related cell types within a specific tissue or organ.

Question 20

Explain the process of erythropoiesis and state three key factors important in this process

Answer 20

Hemocytoblasts—myeloid stem cell(Myeloids stem cells or progenitor cells give rise to RBCS,granulocytes,monocytes(macrophages and dendritic cells. Dendritic cells capture and present antigens to activate T cells in the immune response),platelets ) —-proerythroblast—early erythroblast—late erythroblast—normoblast or orthochromatic erythroblast (nucleated RBC with organelles such as mitochondria)—retuculocyte(young erythrocyte)—mature erythrocyte Erythropoiesis is the process of producing red blood cells (erythrocytes).

Here’s a summary of the steps involved:

1. Stem Cell Stage:
   
   • Starts with hematopoietic stem cells (HSCs) in the bone marrow.
2. Progenitor Cell Stage:
   
   • HSCs differentiate into common myeloid progenitor (CMP) cells.
   • CMP cells further differentiate into erythroid progenitor cells.
3. Precursor Cell Stage:
   
   • Erythroid progenitor cells develop into proerythroblasts.
   • Proerythroblasts undergo several stages, transforming into basophilic erythroblasts, polychromatic erythroblasts, and orthochromatic erythroblasts.
4. Immature Red Blood Cell Stage:
   
   • Orthochromatic erythroblasts expel their nucleus, becoming reticulocytes.
   • Reticulocytes enter the bloodstream and mature into erythrocytes.
5. Mature Red Blood Cell Stage:
   
   • Reticulocytes lose their remaining organelles, becoming fully mature erythrocytes (red blood cells).

• Erythropoietin (EPO): A hormone produced by the kidneys that stimulates erythropoiesis.
• Iron: Essential for hemoglobin synthesis.
• Vitamins: Vitamin B12 and folic acid are crucial for DNA synthesis and cell division.

Erythropoiesis is the production of red blood cells starting from hematopoietic stem cells in the bone marrow, progressing through several stages of differentiation, and culminating in the release of mature erythrocytes into the bloodstream.

Question 21

During third trimester in babies, all bones takes over in haematopoiesis.

State the Dominant sites of haemopoiesis at different stages of development;
1. Fetus 2.infants 3.adults

Answer 21

During third trimester in babies, all bones takes over in haematopoiesis.

Fetus
0-2 months (yolk sac)
2-7 months (liver, spleen)
5-9 months (bone marrow)

Infants-
After birth in the tenth month, primary part is the tibia then as child ages, primary sites are vertebral and plexus,sternum,ribs and femur
Bone marrow (practically all bones); dwindling post-parturition contribution from liver/spleen that ceases in the first few months of life

Adults
Vertebrae, ribs, sternum, skull, sacrum and pelvis, proximal ends of femur

Question 22

After birth, the bone marrow is the exclusive site for haemopoiesis.
What is the exception to this?

Answer 22

Exception: T lymphocytes maturation occur in the thymus in adults.

Question 23

Explain Medullary (Bone marrow) and extramedullary haemopoiesis and where the haematopoiesis occurs in both sides

Answer 23

• Definition: Hemopoiesis (the formation of blood cells) that occurs in the bone marrow.
• Location: Primarily in the bone marrow of the pelvis, ribs, vertebrae, and sternum in adults.
• Process: Includes the production of red blood cells (erythropoiesis), white blood cells (leukopoiesis), and platelets (thrombopoiesis).
• Normal Function: Medullary hemopoiesis is the standard process for producing blood cells in healthy individuals.

• Definition: Hemopoiesis occurring outside the bone marrow.
• Location: Usually in organs like the liver, spleen, and lymph nodes.
• Triggers: Often occurs when the bone marrow cannot meet the body’s blood cell production needs due to:
  
  • Bone marrow diseases (e.g., myelofibrosis, leukemia).
  • Severe chronic anemias (e.g., thalassemia).
  • Increased demand for blood cells (e.g., during fetal development or in certain pathological conditions).
• Significance: Acts as a compensatory mechanism to maintain adequate blood cell levels when bone marrow function is impaired or insufficient.

• Medullary Hemopoiesis:
  
  • Normal, primary site of blood cell production.
  • Located in the bone marrow.
  • Occurs throughout life.
• Extramedullary Hemopoiesis:
  
  • Secondary, compensatory mechanism.
  • Located outside the bone marrow (e.g., liver, spleen).
  • Activated under specific conditions or diseases.

Medullary hemopoiesis is the regular production of blood cells in the bone marrow, essential for maintaining healthy blood cell levels. Extramedullary hemopoiesis occurs outside the bone marrow and typically acts as a backup system when the bone marrow cannot produce enough blood cells due to disease or increased physiological demand.

Sure, let’s incorporate the specified terms into the explanation of medullary and extramedullary hematopoiesis:

• Definition: Hematopoiesis (the formation of blood cells) that occurs in the bone marrow.
• Location: Primarily in the bone marrow of the pelvis, ribs, vertebrae, and sternum in adults.
• Process: Includes the production of red blood cells (erythropoiesis), white blood cells (leukopoiesis), and platelets (thrombopoiesis).
• Normal Function: This is the standard process for producing blood cells in healthy individuals.
• Term: Often referred to as bone marrow medullary hematopoiesis.

• Definition: Hematopoiesis occurring outside the bone marrow.
• Location: Usually in organs like the liver, spleen, and lymph nodes.
• Types:
  
  • Fetal Extramedullary Hematopoiesis: During fetal development, blood cell production occurs in the liver and spleen. This is a normal part of fetal development as the bone marrow is not yet fully functional.
  • Post-Natal Extramedullary Hematopoiesis: After birth, extramedullary hematopoiesis typically occurs as a compensatory mechanism when the bone marrow cannot meet the body’s blood cell production needs. This can be due to:
    
    • Bone marrow diseases (e.g., myelofibrosis, leukemia).
    • Severe chronic anemias (e.g., thalassemia).
    • Increased demand for blood cells.

• Medullary Hematopoiesis:
  
  • Normal Function: Regular production of blood cells in the bone marrow.
  • Location: Bone marrow.
  • Lifespan: Occurs throughout life under normal conditions.
• Extramedullary Hematopoiesis:
  
  • Fetal Stage: Normal and essential during fetal development in organs like the liver and spleen.
  • Post-Natal Stage: Acts as a secondary mechanism when bone marrow function is impaired or insufficient, occurring in organs like the liver, spleen, and lymph nodes.

1. Organ Enlargement and Dysfunction:
   
   • Hepatomegaly: Liver enlargement and potential dysfunction.
   • Splenomegaly: Spleen enlargement, leading to hypersplenism and cytopenias.
   • Lymphadenopathy: Enlarged lymph nodes.
2. Compression Effects:
   
   • Abdominal Discomfort: Due to enlarged organs.
   • Neurological Symptoms: Rarely, spinal cord compression due to hematopoietic tissue in paraspinal areas.
3. Hematological Consequences:
   
   • Anemia: Inadequate red cell production despite increased hematopoiesis.
   • Thrombocytopenia and Leukopenia: Due to hypersplenism.
4. Other Clinical Manifestations:
   
   • Pulmonary Issues: Rarely, respiratory symptoms from pulmonary EMH.
   • Bone Pain: Related to primary bone marrow disease.
5. Diagnostic and Treatment Challenges:
   
   • Difficulty in Diagnosis: EMH can mimic other conditions.
   • Treatment Complications: Managing the underlying disease and considering interventions like splenectomy.

Bone marrow medullary hematopoiesis is the standard, ongoing production of blood cells in the bone marrow. Fetal extramedullary hematopoiesis is a normal process in fetal development, occurring in the liver and spleen. Post-natal extramedullary hematopoiesis occurs outside the bone marrow in response to disease or increased blood cell demand, leading to various clinical consequences and diagnostic challenges.

Question 24

What is emigration and homing in haematopoiesis

Answer 24

• Definition: Homing refers to the process by which hematopoietic stem cells (HSCs) and progenitor cells migrate to and lodge in the bone marrow or other specific tissues where they can proliferate and differentiate.
• Process:
  
  1. Circulation: HSCs circulate in the bloodstream after being released from the bone marrow.
  2. Chemotaxis: Specific signals, such as chemokines (e.g., SDF-1/CXCL12), guide HSCs to their target sites. HSCs originate in the bone marrow, where they reside and proliferate. When needed, they can exit the bone marrow and enter the bloodstream through a process called mobilization.
  3. Migration and Function: Once in the bloodstream, HSCs can migrate to other parts of the body, such as the thymus gland or peripheral lymphoid tissues, where they differentiate and mature into various types of blood cells, including T cells (in the thymus) or B cells (in lymphoid tissues).
  4. Return to Bone Marrow: After completing their tasks in peripheral tissues, some HSCs migrate back to the bone marrow where they divide into other cells which leads to formation of RBCS,wbcs and platelets
  5. Adhesion: HSCs adhere to the bone marrow endothelium via adhesion molecules (e.g., integrins).
  6. Transmigration: HSCs move across the blood vessel wall into the bone marrow.
  7. Lodging: HSCs lodge within the bone marrow niches, where they receive signals to proliferate and differentiate into various blood cells.
• Importance: Ensures that HSCs are properly localized in the bone marrow to maintain steady-state hematopoiesis and respond to hematopoietic demands.

• Definition: Emigration refers to the process by which hematopoietic stem cells and other mature blood cells exit the bone marrow or their primary sites and enter the circulation to reach peripheral tissues.
• Process:
  
  1. Mobilization: HSCs and progenitor cells are mobilized from the bone marrow into the bloodstream. This can be induced by certain cytokines (e.g., G-CSF) or other factors.
  2. Circulation: These cells travel through the bloodstream to reach other tissues.
  3. Extravasation: Cells exit the bloodstream and enter peripheral tissues through the endothelium.
  4. Targeting: Mature blood cells reach their target tissues to perform their specific functions, such as immune response, oxygen transport, or clotting.
• Importance: Allows for the replenishment of blood cells in peripheral tissues, supports immune surveillance, and facilitates tissue repair and response to injury or infection.

• Homing:
  
  • Direction: Movement towards the bone marrow or specific niches.
  • Purpose: Localization of HSCs for proliferation and differentiation.
  • Key Factors: Chemokines (e.g., SDF-1/CXCL12), adhesion molecules (e.g., integrins).
• Emigration:
  
  • Direction: Movement away from the bone marrow into the bloodstream and then to peripheral tissues.
  • Purpose: Distribution of mature blood cells to perform their functions in the body.
  • Key Factors: Cytokines (e.g., G-CSF), mobilization signals.

• Homing Example:
  
  • Bone Marrow Transplantation: HSCs are infused into a patient and must home to the bone marrow to re-establish hematopoiesis.
• Emigration Example:
  
  • Immune Response: Mature lymphocytes migrate from the bone marrow or lymphoid organs into the bloodstream and then to sites of infection or inflammation.

Understanding these processes is crucial for effective therapies in regenerative medicine, hematopoietic stem cell transplantation, and treatments for blood disorders.

Question 25

Haematopoietic stem cells can’t self renew true or false?
What cells do Haematopoietic stem cells differentiate into?

Answer 25

They can self-renew asymmetric cell division.
Self-renew and differentiate into all types of blood cells
They are pluripotent (Multipotent)

Haematopietic stem cells:
They differentiate into either lymphoid progenitor or myeloid progenitor.
The lymphoid one continues to get T lymphocytes and B lymphocytes while myeloid continues to get RBCS,Granulocytes,monocytes,platelets
CD means clusters of differentiation.

Surface markers that play a role in their differentiation into different lineages.

Question 26

How do surface markers help in differentiation of cells
Which cells are CD34 surface markers found on?

Which cells are CD3 surface markers found on?

Which cells are CD45 surface markers found on?

Which cells are CD19 surface markers found on?

Which cells are CD14 surface markers found on?

Answer 26

Surface markers are crucial for hematopoiesis, the process by which blood cells are formed. They help guide the differentiation of stem cells into various blood cell types, such as red blood cells, white blood cells, and platelets. Through interactions with the cell’s environment, including signaling molecules and other cells, surface markers regulate gene expression and determine the fate of the cell. By expressing different combinations of surface markers, cells can be identified and sorted into different populations, aiding in the study and application of hematopoiesis for medical purposes. Surface markers vary depending on the cell type and its stage of differentiation, but some common examples in hematopoiesis include CD34, CD45, CD19, CD3, and CD14. These markers are used to identify and characterize different cell populations within the hematopoietic system. For instance, CD34 is found on hematopoietic stem cells and progenitor cells, while CD45 is expressed on all nucleated hematopoietic cells. CD19 is specific to B cells, CD3 to T cells, and CD14 to monocytes. These surface markers help researchers isolate and study specific cell populations involved in hematopoiesis.

Question 27

How do surface markers help in differentiation of cells
Which cells are CD34 surface markers found on?

Which cells are CD3 surface markers found on?

Which cells are CD45 surface markers found on?

Which cells are CD19 surface markers found on?

Which cells are CD14 surface markers found on?

Answer 27

Surface markers are crucial for hematopoiesis, the process by which blood cells are formed. They help guide the differentiation of stem cells into various blood cell types, such as red blood cells, white blood cells, and platelets. Through interactions with the cell’s environment, including signaling molecules and other cells, surface markers regulate gene expression and determine the fate of the cell. By expressing different combinations of surface markers, cells can be identified and sorted into different populations, aiding in the study and application of hematopoiesis for medical purposes. Surface markers vary depending on the cell type and its stage of differentiation, but some common examples in hematopoiesis include CD34, CD45, CD19, CD3, and CD14. These markers are used to identify and characterize different cell populations within the hematopoietic system. For instance, CD34 is found on hematopoietic stem cells and progenitor cells, while CD45 is expressed on all nucleated hematopoietic cells. CD19 is specific to B cells, CD3 to T cells, and CD14 to monocytes. These surface markers help researchers isolate and study specific cell populations involved in hematopoiesis.

Question 28

What is the term for low production of platelets ?
What about high production?

What is the term for low production of WBCS?
What about high production?

What is the term for low production of RBCS?
What about high production?

Answer 28

Production of RBC
Erythropoiesis

Anaemia (low Hb)
Polycythaemia (high Hb)

Production of WBC-
Leucopoiesis

Leucopenia-low

Leucocytosis-high

Production of PLT Thrombopoiesis

Thrombopocytopenia

Thrombopocyt

Question 29

State five dietary requirements for erythropoiesis

Answer 29

• Nutrients—amino acids, lipids, and carbohydrates
•Iron:
-Stored in Hb (65%), the liver, spleen, and bone marrow
-Stored in cells as ferritin and hemosiderin
-Transported loosely bound to the protein transferrin
•Vitamin B12 and folic acid—necessary for DNA synthesis for cell division

Question 30

What is the lifespan of erythrocytes
What is the fate of erythrocytes and how are erythrocytes destroyed

Answer 30

Life span: 100–120 days

Old RBCs become fragile, and Hb begins to degenerate
•Macrophages engulf dying RBCs in the spleen
•Heme and globin are separated
•Iron is salvaged for reuse
•Heme is degraded to yellow the pigment bilirubin
•Liver secretes bilirubin (in bile)) into the intestines
•Degraded pigment leaves the body in feces as stercobilin
F When red blood cells reach the end of their lifespan (about 120 days), they are removed from circulation by macrophages primarily in the spleen and liver.
2. Heme Catabolism: Once hemoglobin is broken down, heme is released from the globin protein. The heme molecule is then metabolized through a series of steps:
• Biliverdin Formation: Heme is converted into biliverdin by the enzyme heme oxygenase. Biliverdin is green in color.
• Bilirubin Formation: Biliverdin is then converted into bilirubin by the enzyme biliverdin reductase. Bilirubin is yellow-orange in color.
3. Transport and Processing of Bilirubin:
• Unconjugated Bilirubin: Bilirubin produced in the tissues is transported through the bloodstream to the liver, where it undergoes conjugation (binding to glucuronic acid) to form conjugated bilirubin.
• Excretion: Conjugated bilirubin is then excreted into the bile, which enters the intestines. In the intestines, bilirubin is converted into urobilinogen and then into stercobilin (which gives feces its brown color) or reabsorbed into the bloodstream as urobilinogen and excreted in urine (which gives urine its yellow color).
4. Iron Recycling: After heme is broken down, the iron released from heme is either stored in the body’s iron stores or transported to the bone marrow for reuse in new red blood cell production.
•Globin is metabolized into amino acids

Question 31

What is the lifespan of erythrocytes
What is the fate of erythrocytes and how are erythrocytes destroyed
What is heme or iron stored as when the rbc is engulfed by macrophages during rbc destruction?
Iron is Bound to what protein and released to the blood from which organ when erythropoiesis is needed?
What happens to the bilirubin that is gotten from heme?
What is stercobilin?
What is the color of bilirubin?
What is the color of biliverdin?

Answer 31

Life span: 100–120 days

Biliverdin is green
Old RBCs become fragile, and Hb begins to degenerate
•Macrophages engulf dying RBCs in the spleen
•Heme and globin are separated
•Iron is salvaged for reuse
•Heme is degraded to yellow the pigment bilirubin
•Liver secretes bilirubin (in bile)) into the intestines
•Degraded pigment leaves the body in feces as stercobilin

•Globin is metabolized into amino acids

1.Low 02 levels in blood stimulate kidneys to produce erythropoietin.
2 Erythropoietin levels rise in blood.
3 Erythropoietin and necessary raw materials in blood promote erythropoiesis in red bone marrow.
4 New erythrocytes enter bloodstream;
function about 120 days.
5 Aged and damaged red blood cells are engulfed by macrophages
of liver, spleen, and bone marrow; the hemoglobin is broken down.
Hemoglobin is broken down as heme and
Globulin. And bilirubin is also gotten.
Heme or Iron is stored as ferritin,hemosiderin. Iron is Iron ia bound to
transferrin and released to blood from liver as needed for erythropoiesis.
Globulin is converted to amino acids
Bilirubin is picked up from blood by liver, secreted into intestine in bile, metabolized to stercobilin by bacteria, and excreted in feces.

Food nutrients, including amino acids, Fe, B12, and folic acid, are absorbed from intestine and enter blood.
6 Raw materials are made available in blood for erythrocyte synthesis.

Question 32

What is another name for Vit B1,B2,B3,B5,B6,B7,B9 and B12

Answer 32

Another name for vitamin b12-
Cobalamin

Know the different names of the B vitamins
B1-thiamine
B2-riboflavin
B3-niacin
B5-pantothenic acid
B6-pyridoxine
B7-biotin
B9-folate or folic acid (folic acid when included as a supplement)

Timmy’s Rabbits Nibbles Plates and Pans Because of Food and Carrots

Question 33

What is anemia?
State the symptoms of anemia.

Answer 33

Anemia: blood has abnormally low O2-carrying capacity
•A sign rather than a disease itself
•Blood O2 levels cannot support normal metabolism
•Accompanied by fatigue, paleness, shortness of breath, and chills

Question 34

State ten causes of anemia
What is pernicious anemia and how is it treated

Answer 34

1.Insufficient erythrocytes
•Hemorrhagic anemia: acute or chronic loss of blood
•Hemolytic anemia: RBCs rupture prematurely
•Aplastic anemia: destruction or inhibition of red bone marrow

2.Low hemoglobin content:
•Iron-deficiency anemia
•Secondary result of hemorrhagic anemia or
•Inadequate intake of iron-containing foods or
•Impaired iron absorption

Pernicious anemia:
•Deficiency of vitamin B12
•Lack of intrinsic factor needed for absorption of B12
•Treated by intramuscular injection of B12 or application of Nascobal

3. 1.Abnormal hemoglobin:
   •Thalassemias-
   •Absent or faulty globin chain
   •RBCs are thin, delicate, and deficient in hemoglobin

Sickle-cell anemia-
•Defective gene codes for abnormal hemoglobin (HbS)
•Causes RBCs to become sickle shaped in low-oxygen situations

Question 35

How much of total blood volume do leukocytes make up?
How do leukocytes leave the capillaries?
How do they move through the tissue spaces?
What WBc count is leucocytosis

Answer 35

LEUKOCYTES
•Make up <1% of total blood volume
•Can leave capillaries via diapedesis: Diapedesis, also known as transmigration or extravasation, is the process by which white blood cells (leukocytes) move out of the bloodstream and into tissues. This is a crucial step in the immune response, allowing leukocytes to reach sites of infection or inflammation.
•Move through tissue spaces by ameboid motion and positive chemotaxis
•Leukocytosis: WBC count over 11,000/mm3
•Normal response to bacterial or viral invasion

A white blood cell (WBC) count of less than 4 x 109/L indicates leukopenia. A WBC count of more than 11 x 109/L indica

A normal WBC count is typically between 4,000 and 11,000 cells per cubic millimeter (cells/mm³).
A normal WBC count in these units is between 4 and 11 x 10^9 cells/L.

Question 36

Hematopoiesis stem cells are pluripotent. And multipotent. Why?

Answer 36

Pluripotent stem cells arise from totipotent stem cells. The hematopoietic stem cells is pluripotent because it has the ability to differentiate into all types of blood cells. The fact that they can self renew and differentiate make them stem cells.

Pluripotent cause they can differentiate into two pathways major pathways. Either lymphoid or mixed myeloid progenitor pathways. Haematopoietic stem cells are more of pluripotent though but when it differentiates to become either the lymphoid or mixed myeloid,it becomes multipotent

Mixed myeloid progenitor.

They’re multipotent because once they get lymphoid progenitor stage, they have no choice but to differentiate into either T or B lymphocytes. They can’t come back and say oh mistake. I want to be an RBC. Also, once they get to the myeloid progenitor they have no choice but to differentiate into rbcs or platelets or granulocytes or monocytes. They can only follow one pathway and that’s how the hematopoietic stem cells are also multipotent.
There are more options for a pluripotent cell such as an HSC but for a multipotent cell, it has no choice but to become a particular thing once it commits to it.

Question 37

Which cells are the following CDs found on? CD34+ and CD38-
What is the relevance of CD34+ and CD38-
What happens if it becomes CD34+ and CD38+

Answer 37

CD34+ and CD38- markers are used to identify Haematopoietic stem cells .
The plus means the presence of the marker on the stem cell while the minus means its absence. CD34+ is seen on the hematopoietic stem cells while CD38+ is seen on the cells that the hematopoietic stem cells have differentiated into. So if it’s cd38- it means the cd38 marker isn’t active yet which means the hematopoietic stem cell hasn’t differentiated yet. So cd34+/cd38- are on hematopoietic stem cells.
So cd34 and 38 are seen on the blood cells but the plus or minus for the cd38 makes us see which stage the blood cell is at. Is it at haematopoietic stage or it has been differentiated. As the blood cells mature, they lose the expression of cd34 hence they have cd34- and have cd38+. CD38 is a marker found on a variety of cells, including certain immune cells and more differentiated blood cells. In the context of hematopoietic stem cells (HSCs):

• CD38+ cells are typically more mature and differentiated compared to CD38- cells.
• Hematopoietic progenitor cells, which are more differentiated than the primitive HSCs, often express CD38.

So, CD38 is seen on more mature hematopoietic progenitor cells and various other cell types within the immune system, but it is not present on the most primitive hematopoietic stem cells (which are CD34+CD38-).
So, CD34+CD38- cells are the very early blood stem cells in the bone marrow that can develop into all types of blood cells.

There is no difference between “CD34” and “CD34+”; they refer to the same thing.

• CD34 is a marker, a protein found on the surface of certain cells.
• CD34+ indicates that the cells express this marker on their surface.

In the context of stem cells, saying a cell is CD34+ means it has the CD34 marker, which is used to identify and isolate hematopoietic stem cells and progenitor cells in the bone marrow.

Question 38

1. Which of the following is a site of erythropoiesis during development?
   
   • A) Bone Marrow
   • B) Liver
   • C) Spleen
   • D) All of the above
2. The term for the movement of neutrophils towards the site of injury is called:
   
   • A) Diapedesis
   • B) Chemotaxis
   • C) Phagocytosis
   • D) Hemotaxis
3. Which blood cell has a nucleus that is twice the size of a red blood cell?
   
   • A) Neutrophil
   • B) Lymphocyte
   • C) Monocyte
   • D) Eosinophil
     *
4. Which of the following body fluid compartments has the largest number of body fluids?
   
   • A) Intracellular Fluid (ICF)
   • B) Extracellular Fluid (ECF)
   • C) Interstitial Fluid
   • D) Plasma
5. What is the structural composition of hemoglobin?
   
   • A) 4 Globin Chains
   • B) 2 Alpha and 2 Beta Chains
   • C) 4 Heme Groups
   • D) All of the above
   • **
6. Cholesterol is found in which part of the cell membrane?
   
   • A) On the phospholipid head
   • B) Inside the hydrophobic bilayer
   • C) Outside the cell membrane
   • D) Within protein channels
7. An 18-year-old named Ama bleeds profusely during her menstruation. Which type of anemia is she likely to have?
   
   • A) Pernicious Anemia
   • B) Iron Deficiency Anemia
   • C) Aplastic Anemia
   • D) Hemolytic Anemia
   • **
8. Which of the following types of blood cells help with blood clotting?
   
   • A) Erythrocytes
   • B) Leukocytes
   • C) Thrombocytes (Platelets)
   • D) Lymphocytes

How is MCV,MCH,MCHC,PCV,red cell distribution width,hematocrit calculated

Go to ChatGPT and see how these calculations are done
Cuz something like the RBC count, if it’s 5x10 to the power 6, you use only the 5 not the full thing in the calculation

1. Which of the following processes describes the movement of white blood cells toward the site of infection
   
   • A) Diapedesis
   • B) Amoeboid Movement
   • C) Chemotaxis
   • D) Phagocytosis
   **
2. What is the term for the movement of white blood cells out of the bloodstream and into the surrounding tissues?
   
   • A) Chemotaxis
   • B) Diapedesis
   • C) Amoeboid Movement
   • D) Endocytosis
   **
3. Which of the following is involved in guiding white blood cells to specific areas of tissue based on chemical gradients?
   
   • A) Amoeboid Movement
   • B) Chemotaxis
   • C) Diapedesis
   • D) Phagocytosis
   **
4. During which process do white blood cells change shape to move through the endothelial lining of blood vessels?
   
   • A) Chemotaxis
   • B) Diapedesis
   • C) Phagocytosis
   • D) Exocytosis
   **

Which type of movement is characterized by the ability of cells to crawl and change shape by forming temporary projections known as pseudopodia?
• A) Chemotaxis
• B) Ameboid Movement
• C) Diapedesis
• D) Ciliary Movement

Which of the following describes the type of cell movement that involves the extension and retraction of pseudopodia?
• A) Chemotaxis
• B) Diapedesis
• C) Ameboid Movement
• D) Phagocytosis

Answer 38

Here are multiple-choice questions based on your prompts:

1. Which of the following is a site of erythropoiesis during development?
   
   • A) Bone Marrow
   • B) Liver
   • C) Spleen
   • D) All of the above
   • Answer: D) All of the above (Bone marrow, liver, and spleen are all sites of erythropoiesis at different stages of development.)
2. The term for the movement of neutrophils towards the site of injury is called:
   
   • A) Diapedesis
   • B) Chemotaxis
   • C) Phagocytosis
   • D) Hemotaxis
   • Answer: B) Chemotaxis
3. Which blood cell has a nucleus that is twice the size of a red blood cell?
   
   • A) Neutrophil
   • B) Lymphocyte
   • C) Monocyte
   • D) Eosinophil
   • Answer: C) Monocyte
4. Which of the following body fluid compartments has the largest number of body fluids?
   
   • A) Intracellular Fluid (ICF)
   • B) Extracellular Fluid (ECF)
   • C) Interstitial Fluid
   • D) Plasma
   • Answer: A) Intracellular Fluid (ICF)
5. What is the structural composition of hemoglobin?
   
   • A) 4 Globin Chains
   • B) 2 Alpha and 2 Beta Chains
   • C) 4 Heme Groups
   • D) All of the above
   • Answer: D) All of the above (Hemoglobin consists of 4 globin chains and 4 heme groups, with typical adult hemoglobin having 2 alpha and 2 beta chains.)
6. Cholesterol is found in which part of the cell membrane?
   
   • A) On the phospholipid head
   • B) Inside the hydrophobic bilayer
   • C) Outside the cell membrane
   • D) Within protein channels
   • Answer: B) Inside the hydrophobic bilayer
7. An 18-year-old named Ama bleeds profusely during her menstruation. Which type of anemia is she likely to have?
   
   • A) Pernicious Anemia
   • B) Iron Deficiency Anemia
   • C) Aplastic Anemia
   • D) Hemolytic Anemia
   • Answer: B) Iron Deficiency Anemia
8. Which of the following types of blood cells help with blood clotting?
   
   • A) Erythrocytes
   • B) Leukocytes
   • C) Thrombocytes (Platelets)
   • D) Lymphocytes
   • Answer: C) Thrombocytes (Platelets)

Here are the explanations for the MCQs:

1. Which of the following is a site of erythropoiesis during development?
   
   • Explanation: Erythropoiesis occurs in different sites during development. In the fetus, it initially occurs in the yolk sac, then shifts to the liver and spleen, and finally to the bone marrow, which continues to be the primary site after birth.
2. The term for the movement of neutrophils towards the site of injury is called:
   
   • Options: a) Diapedesis, b) Chemotaxis
   • Answer: b) Chemotaxis
   • Explanation: Chemotaxis is the movement of cells towards the source of a chemical signal, such as neutrophils moving towards the site of injury in response to chemotactic factors. Diapedesis refers to the process by which neutrophils move through the walls of blood vessels into tissues, but chemotaxis specifically refers to the directional movement towards injury. Certainly! Here’s a detailed clarification:

1. Chemotaxis:
   
   • Definition: Chemotaxis is the process by which cells move in response to chemical signals. In the context of white blood cells (WBCs), this means they move toward higher concentrations of chemicals (such as cytokines or bacterial products) that indicate a site of infection or injury.
   • Function: It guides WBCs to the location where they are needed, essentially directing their movement through tissues or the bloodstream toward the source of the signal.
2. Diapedesis:
   
   • Definition: Diapedesis is the process by which WBCs move from the bloodstream into the surrounding tissues. This occurs after the WBCs have been directed to the site of injury or infection.
   • Function: It involves the WBCs squeezing through the endothelial cells of blood vessels to reach the tissue where they are needed.

• Chemotaxis directs WBCs to the site of infection or injury by responding to chemical signals.
• Diapedesis allows WBCs to exit the bloodstream and enter the tissue where they can perform their immune functions.

• Chemotaxis is about movement towards the injury based on chemical signals.
• Diapedesis is about the movement out of the blood vessels into the tissue.

So, if a question asks about the movement of WBCs towards the site of injury due to chemical signals, the answer is chemotaxis. If a question is about how WBCs move out of the bloodstream and into the tissues, the answer is diapedesis.

3. Which blood cell has a nucleus twice the size of a red blood cell?
   
   • Explanation: The nucleus of a lymphocyte is roughly the same size as a red blood cell, not twice its size. Large, immature precursor cells in the bone marrow or other white blood cells, like monocytes, might have larger nuclei.
4. Which of the following body fluid compartments has the largest volume of body fluid?
   
   • Explanation: The intracellular fluid (ICF) compartment contains the largest volume of body fluid in the body, making up about two-thirds of the body’s total water content.
5. What is the structural composition of hemoglobin?
   
   • Explanation: Hemoglobin is composed of four polypeptide chains (two alpha and two beta chains) and each chain is associated with a heme group, which binds oxygen.
6. Cholesterol is found in which part of the cell membrane?
   
   • Options: On the phospholipid head, Inside the hydrophobic bilayer
   • Answer: Inside the hydrophobic bilayer
   • Explanation: Cholesterol is embedded within the hydrophobic core of the phospholipid bilayer, where it helps regulate membrane fluidity.
7. An 18-year-old named Ama bleeds profusely during her menstruation. Which type of anemia is she likely to have?
   
   • Explanation: Profuse menstrual bleeding can lead to iron deficiency anemia, which is typically characterized by microcytic, hypochromic red blood cells. This type of anemia results from the loss of iron that is necessary for hemoglobin production. You’re correct—acute blood loss typically causes normocytic anemia. Normocytic anemia means that the red blood cells (RBCs) are of normal size and shape, but their overall number is reduced due to the sudden loss of blood.

In contrast, chronic blood loss, such as what might occur with prolonged heavy menstruation, can lead to iron deficiency anemia, which is often microcytic (smaller than normal RBCs) and hypochromic (paler than normal RBCs).

So, in the case of Ama, who bleeds profusely during menstruation (a chronic condition if it happens over time), the more likely anemia would be microcytic, hypochromic anemia due to iron deficiency.

However, if the bleeding is sudden and severe, it could initially cause normocytic anemia before progressing to iron deficiency anemia if the bleeding continues and iron stores are depleted.

8. Finding the MCV from hemoglobin and hematocrit.
   
   • Explanation: Mean Corpuscular Volume (MCV) is a measure of the average volume of a red blood cell. It can be calculated if hemoglobin and hematocrit values are provided, typically using the formula: MCV = (Hematocrit(%)/RBC count) × 10.

MCHC-hemoglobin/hematocrit x100

PCV-Hbx3

Red cell distribution width- standard deviation of MCV/mean of MCV x100

Hematocrit- Rbc count x MCV/ 10

9. Which of the following types of blood cells help in blood clotting?
   
   • Explanation: Platelets (thrombocytes) are the cell fragments that play a crucial role in blood clotting by forming a platelet plug and facilitating the coagulation cascade.

Which type of movement is characterized by the ability of cells to crawl and change shape by forming temporary projections known as pseudopodia?
• A) Chemotaxis
• B) Ameboid Movement
• C) Diapedesis
• D) Ciliary Movement
Answer: B) Ameboid Movement
Explanation: Ameboid movement involves the formation and retraction of pseudopodia, allowing cells to crawl and change shape.

Which of the following describes the type of cell movement that involves the extension and retraction of pseudopodia?
• A) Chemotaxis
• B) Diapedesis
• C) Ameboid Movement
• D) Phagocytosis
Answer: C) Ameboid Movement
Explanation: Ameboid movement involves the formation of pseudopodia and is used by cells like amoebas and some white blood cells to move and engulf particles.

Here are four MCQs related to the movement of white blood cells (WBCs):

1. Which of the following processes describes the movement of white blood cells toward the site of infection in response to chemical signals?
   
   • A) Diapedesis
   • B) Amoeboid Movement
   • C) Chemotaxis
   • D) Phagocytosis
   Answer: C) ChemotaxisExplanation: Chemotaxis is the process by which white blood cells move towards higher concentrations of chemical signals, such as cytokines, at the site of infection.
2. What is the term for the movement of white blood cells out of the bloodstream and into the surrounding tissues?
   
   • A) Chemotaxis
   • B) Diapedesis
   • C) Amoeboid Movement
   • D) Endocytosis
   Answer: B) DiapedesisExplanation: Diapedesis is the process by which white blood cells squeeze through the endothelial cells of blood vessels to enter the tissues.
3. Which of the following is involved in guiding white blood cells to specific areas of tissue based on chemical gradients?
   
   • A) Amoeboid Movement
   • B) Chemotaxis
   • C) Diapedesis
   • D) Phagocytosis
   Answer: B) ChemotaxisExplanation: Chemotaxis involves movement towards a chemical signal, helping direct white blood cells to specific areas.
4. During which process do white blood cells change shape to move through the endothelial lining of blood vessels?
   
   • A) Chemotaxis
   • B) Diapedesis
   • C) Phagocytosis
   • D) Exocytosis
   Answer: B) DiapedesisExplanation: During diapedesis, white blood cells change shape and pass through the endothelial cells of blood vessels to reach the tissue.

Question 39

Normal amount of blood in a how much kg?? Assignment
4.5 to 5 litresfemale
5-6 litres male

The normal blood volume in a person generally depends on their body weight and sex. The typical blood volume can be estimated as follows:

•	For males: Approximately 70 mL/kg of body weight.
•	For females: Approximately 65 mL/kg of body weight.

Based on this, for a person weighing:

•	70 kg male: Blood volume ≈ 70 mL/kg × 70 kg = 4.9 liters.
•	70 kg female: Blood volume ≈ 65 mL/kg × 70 kg = 4.55 liters.

These estimates fit within the general ranges provided:

•	Males: 4.5 to 5 liters.
•	Females: 5 to 6 liters.

For a person weighing 70 kg, the typical blood volume would be approximately 4.5 to 5 liters for males and around 4.55 liters for females.

One pint of blood is 500mls
So 5 litres is 10pints

Most common site for blood draw of venous blood-
Antecubital fossa from median cubital vein

What about arterial blood?
Most commonly performed at the radial artery in the wrist. The brachial artery is used in some cases, and the femoral artery is used less frequently and usually in specific clinical scenarios.

Brachial Artery: Located in the antecubital fossa (inner elbow), though less commonly used due to the proximity to major veins and nerves.
• Femoral Artery: Located in the groin area, used in specific clinical situations.

The radial artery is preferred for arterial blood gas (ABG) sampling due to its accessibility and relatively low risk of complications.

Two main components:
Fluid part and cellular part is gotten after centrifuging.

45percent is for packed rbcs obtained after centrifuging

Plasma:
Water92%
Proteins-7%
Solute-the rest

Albumin transports substances that aren’t soluble in water
Globulin- infections
Coagulation factors are in plasma

Your summary of plasma composition is generally accurate. Here’s a bit more detail:

• Plasma is the liquid component of blood and makes up about 55% of total blood volume.

• Water: Approximately 92% of plasma. It acts as the primary solvent for transporting substances.
• Proteins: About 7% of plasma. Key proteins include:
  
  • Albumin: The most abundant plasma protein (about 60% of total plasma proteins). It helps maintain oncotic pressure and transports hydrophobic substances such as fatty acids, hormones, and certain drugs.
  • Globulins: Includes alpha, beta, and gamma globulins, which function in transport, immune response, and other roles.
  • Fibrinogen: Essential for blood clotting.
• Solutes: The remaining 1%, which includes electrolytes (sodium, potassium, chloride), nutrients (glucose, amino acids), hormones, and waste products (urea, creatinine).

Albumin is crucial for maintaining the osmotic pressure of blood and for transporting substances that are not soluble in water, including fatty acids, hormones, and certain medications.

Formed elements of blood: why are they called so instead of blood cells?
Platelets are not cells. They are fragments from a cell but not cells in themselves.

Hematopoiesis starts 3rd week of gestation and is transient

Why is stem cell division asymmetrical?
From The two daughter cells produced, One remains a stem cell to keep stem cell pool while
One differentiates into the blood cells

Stem cells Are pluripotent but as they differentiate, they become multipotent

The blood elements grow in bone marrow and mature then they move into the blood and some continue the maturation or differentiation process in the tissues. Examples are Mast cells in tissues, macrophages in tissues, dendritic cells in tissues,

Sites of hematopoiesis :
In infants, all cells or bones are hematopoietically active. Occurs in red bone marrow cuz most of bones have red bone marrow for infants.
As you age, it becomes 50 red bone Amaris, 50 yellow bone marrow
Then keeps reducing until most is yellow bone marrow
After birth, not all bones are hematopoietic

T lymphocytes complete part their maturation in thymus

Bone marrow and thymus are primary lymphoid organs.
Spleen,tonsils and lymph nodes are secondary lymphoid organs and Deal with matured lymphocytes in that they clear it from circulation

Your classification of lymphoid organs is correct. Here’s a detailed overview:

1. Bone Marrow:
   
   • Function: Site of hematopoiesis (production of blood cells) and maturation of B lymphocytes (B cells).
   • Role: Produces and matures all blood cells, including the precursors to lymphocytes.
2. Thymus:
   
   • Function: Site where T lymphocytes (T cells) mature.
   • Role: T cells migrate from the bone marrow to the thymus to undergo maturation and selection.

1. Spleen:
   
   • Function: Filters blood, removes old or damaged blood cells, and serves as a site for immune responses.
   • Role: Contains white pulp that supports the activation of B and T lymphocytes, and red pulp for filtering blood and removing old red blood cells.
2. Tonsils:
   
   • Function: Act as a first line of defense against inhaled or ingested pathogens.
   • Role: Contain lymphoid tissue that monitors and responds to pathogens in the throat and oral cavity.
3. Lymph Nodes:
   
   • Function: Filter lymphatic fluid and house lymphocytes.
   • Role: Trap pathogens and present them to lymphocytes, which can then mount an immune response.

• They are involved in the activation and proliferation of mature lymphocytes (B and T cells) that have migrated from the primary lymphoid organs.
• They also play a role in filtering and clearing pathogens and dead cells from the circulation.

In summary, primary lymphoid organs are where lymphocytes develop and mature, while secondary lymphoid organs are where these mature lymphocytes perform their immune functions.

Factors affecting hematopoiesis:
- [ ] Healthy bone marrow and healthy stem cells
- [ ] Nutrients such as iron
- [ ] Growth factors. General growth factors-IL-1. Specific growth factors- Thrombopoitein,Erythropoietin,IL-5 for Eosinophils

Bone marrow in haemopoiesis :
Macrophages store ions so they help in rbcs production
Fibroblasts or adhesive molecules holds rbcs so they’re not displace into other organs

Cytokines control proliferation survival and death of progenitors

MEGAKARYOCTE LISTENS TO NEGATIVE FEEDBACK.
Mature lymphocytes and macrophages produce CSF
DiffereNTIATION OCCURS WHEN THE CELLS HAVE a particular sort of CD or so that commits it to a particular lineage.
Differentiation occurs and causes reduce in size and increase in number in erythrocytes

Kidneys produce EPo in response to low oxygen levels
Athletes have high RBC count
People with high altitudes have high rbcs

Platelets 7-10 days
Units of measurements of the rbcs

Sodium citrate tube is for coagulation studies. Colour on top is blue
EDTA Anticoagulant tube is for FBC,sickling AND BLOOD SMEARS
EDTA Chelates calcium.

Triphan biopsy:
Invasive techniques for people who have had cancer and the cancer has spread.
If you can’t use blood to determine what is going on.
Bone marrow samples are taken from posterior iliac crest (hip bone)

At sea level and above sea level can affect hb levels.

Difference between nuetrophils in hashtag and neutrophils in percentage.

Automated hematology analyzer produces FBC results

To analyze blood, you first start with:
- [ ] Fbc
- [ ] Blood film comment-blood smear and checking morphology

Here’s an overview of the components of a full blood count (FBC), the use of sodium citrate tubes, bone marrow biopsy, and how altitude affects hemoglobin levels:

1. Red Blood Cell (RBC) Count:
   
   • Units: Millions per microliter (million/µL) or (x10^6/µL).
   • Normal Range: Typically 4.5-5.9 million/µL for males and 4.1-5.1 million/µL for females.
2. Hemoglobin (Hb):
   
   • Units: Grams per deciliter (g/dL).
   • Normal Range: Approximately 13.8-17.2 g/dL for males and 12.1-15.1 g/dL for females.
3. Hematocrit (Hct):
   
   • Units: Percentage (%).
   • Normal Range: About 40.7%-50.3% for males and 36.1%-44.3% for females.
4. Mean Corpuscular Volume (MCV):
   
   • Units: Femtoliters (fL).
   • Normal Range: Typically 80-100 fL.
5. Mean Corpuscular Hemoglobin (MCH):
   
   • Units: Picograms per cell (pg/cell).
   • Normal Range: Approximately 27-31 pg/cell.
6. Mean Corpuscular Hemoglobin Concentration (MCHC):
   
   • Units: Grams per deciliter (g/dL).
   • Normal Range: About 33.4-35.5 g/dL.
7. Red Cell Distribution Width (RDW):
   
   • Units: Percentage (%).
   • Normal Range: Typically 11.5%-14.5%.

• Purpose: Used for coagulation studies (e.g., PT, aPTT).
• Color: Blue top on the tube indicates sodium citrate as an anticoagulant.

• Purpose: An invasive technique used to assess bone marrow for diseases such as leukemia, lymphoma, or multiple myeloma, especially when cancer has spread or other diagnostic methods are inadequate.
• Site: Bone marrow samples are commonly taken from the posterior iliac crest (hip bone) for analysis.

• At Sea Level: Hemoglobin levels are generally within the normal range.
• Above Sea Level: In higher altitudes, hemoglobin levels can increase as an adaptive response to lower oxygen levels. The body produces more red blood cells to enhance oxygen transport.

1. Neutrophils in Absolute Count:
   
   • Units: Cells per microliter (cells/µL).
   • Normal Range: Approximately 1,500-8,000 cells/µL.
2. Neutrophils as a Percentage:
   
   • Units: Percentage (%).
   • Normal Range: Typically 40%-70% of the total white blood cell count.

• Difference: Absolute neutrophil count refers to the total number of neutrophils in a given volume of blood, while the percentage of neutrophils reflects the proportion of neutrophils relative to the total white blood cell count.

Absolute Count vs. Percentage:
- Absolute Neutrophil Count (ANC): This is the total number of neutrophils present in a given volume of blood (e.g., cells/µL). It provides a direct measure of neutrophil quantity.

• Percentage of Neutrophils: This indicates the proportion of neutrophils relative to the total number of white blood cells (WBCs) in the blood.

Why Absolute Count Might Be Higher:
- If the total white blood cell count (WBC) is low or normal but the absolute count of neutrophils is high, the percentage of neutrophils might seem relatively lower. Conversely, if the WBC count is high and the neutrophil count is proportionally high, the percentage might appear high but the absolute count will be a higher number due to the increased overall WBC count.

For example:
- If the total WBC count is 10,000 cells/µL and neutrophils are 70% of this, then:
- Neutrophils (percentage): 70% of 10,000 = 7,000 cells/µL.
- If the total WBC count is 5,000 cells/µL and neutrophils are 70% of this, then:
- Neutrophils (percentage): 70% of 5,000 = 3,500 cells/µL.

Triphen Biopsy (often referred to as “triple-phase biopsy” or similar):

• Purpose: This term typically refers to a biopsy technique used for evaluating certain conditions, particularly in cancer diagnosis, to assess the extent and nature of disease spread.
• Process: Involves obtaining tissue samples through various phases or techniques to get a comprehensive understanding of the pathology. For example, a triphasic biopsy might include:
  • Initial Biopsy: To obtain a preliminary sample.
  • Follow-up Biopsies: To assess response to treatment or disease progression.
  • Additional Imaging or Sampling: To check for metastases or other affected areas.

In some contexts, “triphen” might be a misinterpretation or a specific term related to particular diagnostic protocols used in oncology. However, the precise term might be less standardized, and exact procedures can vary based on medical practice and the specific condition being investigated.

Answer 39

The normal blood volume for males and females, along with typical body weights, can be summarized as follows:

• Average Body Weight: Approximately 70 kg
• Normal Blood Volume: 5 to 6 liters
• Body Water Content: About 60% of body weight, which is approximately 42 liters (for 70 kg).

• Average Body Weight: Approximately 60 kg
• Normal Blood Volume: 4 to 5 liters
• Body Water Content: About 50-55% of body weight, which is approximately 30 to 33 liters (for 60 kg).

• Males: 5 to 6 liters of blood, about 42 liters of body water (60 kg body water content).
• Females: 4 to 5 liters of blood, about 30 to 33 liters of body water (50-55% body water content).

These values can vary based on individual factors like age, activity level, and overall health.

Question 40

Pro normoblasts or proerythroblast is the first cell you’ll identify under a microscope when you take blood sample from the bone marrow.
Normoblasts or nucleated rbcs are not present in normal periphery blood.

How many erythrocytes can be Produced from one pro normoblasts?? 16

Reticulocytes won’t have nucleus but contains rna remnants so it can still produce Hb.
When nucleus removes from the rbc, the name of the cell is called reticulocytes.

Reticulocytes count indicates the erythropoietic activities. So if the reticulocytes are plenty or the count is high, it means the bone marrow is producing a lot of rbcs
And if the reticulocytes count is low, it means bone marrow will reduce production
Check if what you just typed is correct

Normoblasts in peripheral blood means;
Bone marrow is producing more cells into circulation cuz body is breaking down more than usual ,bone marrow disease,malignancies
If the hemolysis is so severe, the bone marrow can push immature rbcs into the peripheral blood to try to makeup for what is going on. Those immature rbcs is also called normoblasts or nucleated rbcs

Hb 65% in which part of the erythropoiesis

Immature cells are also bunch in the peripheral Blood in the sickle cell people cuz they’re also undergoing serious hemolysis

B12 and folate help the nucleus to mature well
Folate for production of iron
Function Vit c in Erythropoiesis

Problem with absorption of minerals and vitamins in the body for erythropoiesis will cause what problem?

Without hemoglobin,the rbc is useless

I’m g6pd deficient people, cells are broken down before 120 days

Common stain in Ghana- leishman stain(this is from Romanowsky stain )or peripheral Blood thin films

Exhaustion is the common sign of anemia.
Anemia occurs due to either reduced rbc or reduced hb

Point mutation occurs in sickle cell disease when the amino acid switches
One alpha instead of 2 alpha- beta thalassemia (check)
Alpha thalassemia

Iron 2+. The iron must be in the reduced state to be get heme.
Without iron, you can’t get heme to complex with globins to get hemoglobin

Low MCH- hypochromic
High MCH- hyperchromic

Check normal rbc count

Microcytic hypochromic anemia

Fbc
Blood film or smear- for
Morphology
Serum iron studies-iron deficiency anemia or
Serum b12 or folate studies- suspecting Vit b 12 deficiency

Anemia: reduced oxygen carrying capacity due to dysfunctional rbcs or reduced hb
How thalassemia causes anemia : normal rbc count but Mcv or mch may be low. In thalassemia, it’s common to see a normal or slightly elevated RBC count but with reduced MCH (mean corpuscular hemoglobin) and MCV (mean corpuscular volume). Here’s why:

• In thalassemia, especially mild forms like thalassemia trait, the body tries to compensate for the anemia by producing more red blood cells. This results in a normal or slightly increased RBC count, despite the presence of smaller and less effective red blood cells.

• MCV measures the average size of the red blood cells. In thalassemia, the red blood cells are smaller (microcytic) because there is not enough hemoglobin being produced due to the deficiency of alpha or beta globin chains.
• MCH measures the average amount of hemoglobin in each red blood cell. In thalassemia, the red blood cells contain less hemoglobin (hypochromic), so the MCH is reduced.

• In thalassemia, the imbalance in globin chain production leads to underproduction of hemoglobin, so each red blood cell carries less hemoglobin than normal (lower MCH).
• The red blood cells are also smaller (lower MCV) because less hemoglobin is available to fill them.
• However, the body tries to compensate for this reduced hemoglobin by making more red blood cells, which is why the RBC count may stay normal or even increase slightly.

In summary, the body compensates for the defective hemoglobin production by increasing the number of red blood cells, but these cells are smaller and contain less hemoglobin, leading to reduced MCV and MCH.

Dark palms for megaloblastic anemia(Vit b12 deficiency)

Anemia is an incomplete diagnosis

Macrophages in bone marrow:

Colour size and shape as morphological features of rbcs under microscope

Pallor as a sign in anemia is quite general and won’t give you the specific cause of the anemia but pallor with jaundice is specific cuz it shows it’s a hemolytic anemia

Answer 40

That’s almost correct!

Reticulocyte count indeed reflects erythropoietic activity, indicating the bone marrow’s production of new red blood cells (RBCs). Here’s a nuanced correction:

High Reticulocyte Count:

• Indicates increased bone marrow production of RBCs, usually in response to:
  
  • Anemia (e.g., iron deficiency, vitamin deficiency)
  • Blood loss
  • Hemolysis (RBC destruction)
• Suggests the bone marrow is actively trying to replace lost or damaged RBCs.

Low Reticulocyte Count:

• Indicates decreased bone marrow production of RBCs, possibly due to:
  
  • Bone marrow failure or dysfunction
  • Inadequate erythropoietin (EPO) production
  • Chronic diseases (e.g., kidney disease, cancer)
  • Nutrient deficiencies (e.g., iron, vitamin B12)
• Does not necessarily mean the bone marrow will reduce production, but rather that production is already impaired.

To clarify, a low reticulocyte count doesn’t directly cause the bone marrow to reduce production. Instead, it indicates an existing problem with RBC production.

Keep in mind that reticulocyte count should be interpreted in context with other laboratory results, medical history, and clinical presentation.

Question 41

What are quantitative and qualitative deficiencies
Sickle cell is what type of deficiency

Heme contains a porphyrin ring, specifically a type called protoporphyrin IX. This ring structure is essential because it binds to an iron ion (Fe²⁺), which is crucial for the oxygen-carrying ability of hemoglobin. The iron atom sits at the center of the porphyrin ring and can bind oxygen molecules, allowing heme to transport oxygen throughout the body.

If you give oral Vit B12 to someone with pernicious anemia, the person will still produce big rbcs cuz they don’t have the intrinsic factor. So you need to solve the lack of intrinsic factor problem.

Aetiological classification of anemia finds out the cause of the anemia. Example; is patient bleeding or not?

You compare the rbc with the nucleus of the small lymphocyte to determine if it’s of normal size
If the central pallor is more than 1/3rd of the rbc, it’s hypochromic. Hypochromic means there isn’t enough hb in the rbc. We don’t really have hyperchromic cuz you can’t pack more hb into an rbc. If there is more hb, the rbc will
Lose its central pallor. This abnormality is called spherocytosis cuz the rbc wouldn’t have a central pallor. The sphere shape makes them lose the central pallor so more hb or higher concentration will be in it cuz their volume is reduced cuz of the new shape.

However, due to the increased destruction of these spherocytes in the spleen, overall hemoglobin levels may drop, leading to anemia. Therefore, while each spherocyte contains more hemoglobin, the total hemoglobin in circulation may be lower due to increased hemolysis.

If there isn’t any lymphocyte to compare with, you can use the neutrophils to compare

If there are many normoblasts cells in your blood, the machine may count it as lymphocytes cuz it’s closer to a lymphocyte cuz of the fact that it has a nucleus and it’s big too.

Pencil cell in blood smear indicates iron deficiency anemia

Microcytic hypochromic anemia:
Iron deficiency anemia
Anemia of chronic disease
Thalassemia
You do hb electrophoresis if you’re suspecting thalassemia

RBCS are still normal (normocytic normochromic) if patient is bleeding acutely.
When the bleeding becomes chronic, it becomes microcytic

I’m the history, you want to know if they’ve had a surgery where part of their gut was taken out cuz that can cause lack of intrinsic factor so which part of the intestine is intrinsic factor located?
Ask the kind of drugs they’re taking.
Family history of such diseases

Answer 41

Quantitative deficiencies refer to conditions where there is a reduced amount or total absence of a particular substance, cell, enzyme, or molecule in the body. In this case, the affected component is present but in insufficient quantities. Examples include:

• Anemia: A reduced number of red blood cells (RBCs).
• Neutropenia: A lower-than-normal number of neutrophils (a type of white blood cell).
• Enzyme deficiency: Like in glucose-6-phosphate dehydrogenase (G6PD) deficiency, where the enzyme is produced in lower amounts.

Qualitative deficiencies refer to conditions where the substance or cell is present in normal amounts, but its function or structure is abnormal, making it ineffective or dysfunctional. Examples include:

• Sickle cell anemia (HbS): Hemoglobin is produced in normal quantities, but its abnormal structure leads to sickling of red blood cells.
• Alpha-1 antitrypsin deficiency: The protein may be present, but its structure is defective, leading to improper function in protecting the lungs.

In summary, quantitative deficiencies involve low amounts of a component, while qualitative deficiencies involve normal amounts of a defective or dysfunctional component.

Question 42

Iron deficiency begins in stages. First, person depletes iron stores before iron stores in rbc will be depleted so if you want to know it’s cuz of reduced iron, you’ll have to do ferritin studies .

Iron deficiency anemia takes time for the person to become anemic unless person is actively bleeding.iron deficiency anemia occurs over time cuz it takes long for iron stores to be depleted for it to even show in your RBCS for them to become microcytic hypochromic.

After the depletion of iron stores, the progression of iron deficiency occurs in the following stages:

1. Depletion of iron stores (Stage 1): Ferritin levels, which reflect stored iron, begin to decrease. However, hemoglobin levels and red blood cell production are still normal at this stage.
2. Iron-deficient erythropoiesis (Stage 2): As iron stores are depleted, the body has less iron available for hemoglobin production. Serum iron levels decrease, transferrin saturation drops, and red blood cells start to become smaller (microcytic) and paler (hypochromic) due to reduced hemoglobin content. However, hemoglobin levels may still remain within the normal range.
3. Iron deficiency anemia (Stage 3): This is the final stage, where there is insufficient iron to produce adequate hemoglobin, leading to anemia. Hemoglobin levels drop below normal, and red blood cells become noticeably microcytic and hypochromic.

At this stage, symptoms of anemia like fatigue, weakness, and pallor become more apparent.

Red cell distribution width shows you the variations in the sizes of the rbcs

Difference between MCH and MCHC

Colors and characteristics of granules and pigments of cells to classify granulocytes.

Monoblasts and myeloblasts are difficult to differentiate under light microscope so they’re both normally referred to as myeloblasts under the microscope

Yes, granulocytes typically have segmented nuclei with multiple lobes. The extent of lobulation varies among the different types of granulocytes:

1. Neutrophils – Have a multi-lobed nucleus (usually 3-5 lobes), which is why they are often referred to as “polymorphonuclear” leukocytes (PMNs).
2. Eosinophils – Typically have a bilobed nucleus, though sometimes it may appear multi-lobed.
3. Basophils – Usually have a bilobed or S-shaped nucleus, but it is often obscured by the large granules in the cytoplasm.

The lobulation of the nucleus helps in the flexibility and movement of these cells, allowing them to migrate through tissues more easily during immune responses.

Hypersegmented neutrophil is indicative of megaloblastic anemia. Yes, hypersegmented neutrophils are often seen alongside macrocytes in the blood smear of a person with megaloblastic anemia. The condition is characterized by both:

•	Macrocytes: Larger-than-normal red blood cells (MCV > 100 fL), which result from impaired DNA synthesis that affects the maturation of erythrocytes.

Yes, examining pathologies under the microscope is typically considered a qualitative analysis. This type of analysis focuses on morphological features, such as the shape, structure, and appearance of cells and tissues, rather than numerical or measurable values.

When pathologists look for abnormalities in tissues or cells (e.g., the size and shape of red blood cells, the presence of hypersegmented neutrophils, or abnormal cell structures), they are making qualitative observations. These findings are descriptive and used to make a diagnosis based on visual interpretation. In contrast, quantitative analysis would involve measuring specific values, such as cell counts or hemoglobin concentration, which are numerical data.

Granulocytes plus monocytes are phagocytes

Immunocytes are lymphocytes that differentiate into antibodies

Neutrophils are abundant for bacterial and fungal infections
Eosinophils:
Parasitic
Basiphils:allergies, investigate for a malignancy if the basiphils are way too much.

Monocytes are phagocytic but engulf bigger pathogens than neutrophils cuz the monocytes are bigger than neutrophils.

Neutrophils are also for pyogenic infections

Eosinophils release their granulesunto the parasites to destroy them

Granules are used to destroy the pathogens
The granules in certain immune cells, particularly granulocytes, contain various digestive enzymes and other substances that help digest and kill pathogens. Here’s a breakdown of the content of these granules in different granulocytes:

1. Neutrophils:
   
   • Primary (azurophilic) granules: Contain enzymes like myeloperoxidase, lysozyme, defensins, and acid hydrolases, which are important for breaking down bacterial cell walls and generating reactive oxygen species (ROS) for microbial killing.
   • Secondary (specific) granules: Contain lactoferrin, lysozyme, and collagenase, which help in bacterial digestion and tissue remodeling.
   • Tertiary granules: Contain gelatinase, which helps in degrading the extracellular matrix during neutrophil migration.
2. Eosinophils:
   
   • Granules contain major basic protein (MBP), eosinophil cationic protein (ECP), and eosinophil peroxidase (EPO). These are toxic to parasites and also play a role in immune responses and inflammation.
3. Basophils:
   
   • Granules contain histamine, heparin, and proteolytic enzymes. While basophils are mainly involved in allergic responses, the proteases can break down pathogens.

These granules are essential for the phagocytic process, where the pathogen is engulfed and digested within the immune cells.

Answer 42

The key difference between MCH (Mean Corpuscular Hemoglobin) and MCHC (Mean Corpuscular Hemoglobin Concentration) lies in what they measure:

1. MCH (Mean Corpuscular Hemoglobin):
   
   • Measures the average amount of hemoglobin in a single red blood cell.
   • It is expressed in picograms (pg).
   • Calculation:
     [
     \text{MCH} = \frac{\text{Hemoglobin/RBC count}}
     ]
   • Interpretation: MCH reflects the absolute amount of hemoglobin in each red blood cell, but it does not account for the size of the cell. Low MCH can indicate microcytic anemia, while high MCH can indicate macrocytic anemia.
2. MCHC (Mean Corpuscular Hemoglobin Concentration):
   
   • Measures the average concentration of hemoglobin in a given volume of red blood cells.
   • It is expressed in grams per deciliter (g/dL).
   • Calculation: MCHC} = {Hemoglobin/Hematocrit}} times 100]
   • Interpretation: MCHC reflects how “packed” hemoglobin is inside the red blood cells. Low MCHC can indicate hypochromic anemia (such as iron deficiency anemia), while high MCHC is seen in conditions like hereditary spherocytosis.

In summary, MCH looks at the amount of hemoglobin per red blood cell, while MCHC measures the concentration of hemoglobin relative to the size of the red blood cells.

Question 43

Calculating absolute wbc count from relative wbc percentage and wbc count

Learn the different rbc indices and their units

• Definition: The absolute white blood cell (WBC) count is the total number of white blood cells in a specified volume of blood, typically expressed as cells per microliter (cells/µL) or per liter (cells/L). It provides a direct measure of the quantity of WBCs present in circulation.

• Definition: The relative WBC count refers to the percentage of each type of white blood cell compared to the total white blood cell count. It indicates the proportion of different WBC types (e.g., neutrophils, lymphocytes, monocytes) within the overall WBC population.

Answer 43

Absolute wbc count=relative wbc percentage of type you’re looking for/100 x the WBC count

Relative wbc percentage = absolute wbc count of the type you’re looking for / total wbc count x 100

Total WBC COUNT= absolute neutrophils + absolute lymphocytes+absolute monocytes + absolute eosinophils + absolute basiphils

The relative percentages of different types of white blood cells (WBCs) adding up to 100% means that these percentages represent the proportions of each specific WBC type within the total population of white blood cells. In a complete blood count (CBC), the sum of the relative percentages of all WBC types (neutrophils, lymphocytes, monocytes, eosinophils, and basophils) should ideally equal 100%.

Yes, that’s correct! When you add the absolute counts of each type of white blood cell together, they should equal the total WBC count if it is available. This serves as a check to ensure that your calculations are accurate and that all types of WBCs have been accounted for.

If you calculated the absolute counts as follows:
- Neutrophils: 4,800 cells/µL
- Lymphocytes: 2,400 cells/µL
- Monocytes: 400 cells/µL
- Eosinophils: 240 cells/µL
- Basophils: 160 cells/µL

You would sum these absolute counts:
[
4,800 + 2,400 + 400 + 240 + 160 = 8,000 \text{ cells/µL}
]

If the total WBC count you have is also 8,000 cells/µL, this confirms that your calculations are consistent and correct. This verification step is essential in clinical settings to ensure accurate diagnosis and treatment planning.

Question 44

Yes, that’s correct:

• Red Blood Cells (RBC) are typically counted in units of millions per microliter (cells/µL), often expressed as cells × 10^6/µL, or simply as cells × 10^12/L.
• White Blood Cells (WBC) are counted in units of thousands per microliter (cells/µL), expressed as cells × 10^3/µL, or cells × 10^9/L.

To summarize:
- RBC count is often referred to as × 10^12/L.
- WBC count is often referred to as × 10^9/L.

PDW (Platelet Distribution Width) and MPV (Mean Platelet Volume) are both hematological indices related to platelets.

• Definition: PDW measures the variability in the size of platelets in a blood sample. It reflects the range of platelet sizes, indicating the degree of anisocytosis (variation in size).
• Clinical Significance: A higher PDW may suggest an increased response to platelet activation or production, often seen in conditions like inflammation, thrombocytopenia, or certain myeloproliferative disorders.

• Definition: MPV measures the average size of platelets in a blood sample. Larger platelets are typically younger and more reactive.
• Clinical Significance: An increased MPV can indicate active platelet production and is often associated with conditions like thrombocytopenia or inflammatory diseases. Conversely, a low MPV may suggest decreased platelet production.

Both indices provide valuable information about platelet function and production in various clinical contexts.

Yes, that’s correct! The absolute reticulocyte count is expressed in the same unit as the RBC count, typically as cells per liter (cells/L) or cells per microliter (cells/µL), often noted as × 10^9/L for both.

• For example, if you have a reticulocyte count of 50 × 10^9/L, it is reported in the same manner as an RBC count of 5.0 × 10^12/L.

This similarity in units allows for easier comparison and interpretation of the data regarding red blood cell production and turnover.

The reticulocyte count is typically expressed as a percentage of the total red blood cell (RBC) count or in absolute numbers. The units can be:

1.	Percentage: Reticulocytes are reported as a percentage of the total RBC count (e.g., 1.5%).
2.	Absolute count: When reported in absolute terms, it is often expressed as cells per microliter (cells/µL) or cells per liter (cells/L), commonly as thousands per microliter (e.g., 50,000 cells/µL, or 50 × 10^3/µL).

Reticulocyte counts help evaluate bone marrow function and assess response to anemia or other hematological conditions.

Here are five application-based MCQs that assess your understanding of red cell indices:

The following are uses of reticulocyte count except:
A) Assessing bone marrow response to anemia
B) Diagnosing iron deficiency anemia
C) Monitoring response to treatment in anemia
D) Evaluating red blood cell production

Answer: B) Diagnosing iron deficiency anemia
Explanation: While reticulocyte counts can indicate bone marrow response, they do not specifically diagnose iron deficiency anemia.

Which of the following statements regarding mean corpuscular volume (MCV) is false?
A) MCV is used to classify anemias as microcytic, normocytic, or macrocytic.
B) An elevated MCV can indicate vitamin B12 deficiency.
C) MCV is the average size of red blood cells.
D) MCV is unaffected by hydration status.

Answer: D) MCV is unaffected by hydration status.
Explanation: MCV can be influenced by hydration status, as dehydration can falsely elevate hemoglobin levels and lead to a falsely low MCV.

A patient presents with a reticulocyte count of 0.5% and a low hemoglobin level. What does this indicate?
A) High bone marrow activity
B) Low bone marrow production of red blood cells
C) Normal red blood cell turnover
D) Recent blood loss

Answer: B) Low bone marrow production of red blood cells
Explanation: A low reticulocyte count in the setting of anemia suggests inadequate production of red blood cells by the bone marrow.

Which of the following conditions would likely result in an elevated RDW (Red Cell Distribution Width)?
A) Iron deficiency anemia
B) Sickle cell disease
C) Thalassemia
D) All of the above

Answer: A) Iron deficiency anemia
Explanation: Iron deficiency anemia typically shows elevated RDW due to increased variability in red blood cell size, while thalassemia usually has a normal RDW.

What does a high mean corpuscular hemoglobin concentration (MCHC) typically indicate?
A) Iron deficiency anemia
B) Spherocytosis
C) Macrocytic anemia
D) Aplastic anemia

Answer: B) Spherocytosis
Explanation: A high MCHC is often associated with conditions like spherocytosis, where red blood cells are more concentrated due to their shape and reduced volume.
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In sickle cell disease, the red blood cells are often uniformly sickle-shaped, which typically leads to a relatively normal RDW. The red blood cells do not vary significantly in size because they share a common morphology.

In contrast, iron deficiency anemia is characterized by a mix of microcytic and normocytic red blood cells, resulting in a higher RDW due to increased variability in cell size.

So, while sickle cell disease can present with other abnormalities in red cell indices, it usually does not cause an elevated RDW like iron deficiency anemia does.

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Question 45

The reticulocyte count is an important laboratory test used to assess the bone marrow’s response to anemia and to evaluate erythropoiesis (red blood cell production

A 30-year-old woman presents with sudden onset of anemia after heavy menstrual bleeding. A high reticulocyte count suggests which underlying condition?”
• Answer: Active marrow response to blood loss (suggesting acute hemorrhage).

In evaluating conditions that affect bone marrow function (e.g., aplastic anemia or myelodysplastic syndromes).
• Question Example: “In a patient with suspected aplastic anemia, which test would provide information on the bone marrow’s ability to produce new red blood cells?”
• Answer: Reticulocyte count.

In cases where hemolysis is suspected, a high reticulocyte count indicates active red blood cell production in response to increased destruction.
• Question Example: “A patient presents with jaundice and splenomegaly. Which laboratory test would help confirm a diagnosis of hemolytic anemia?”
• Answer: Reticulocyte count.

High Reticulocyte Count: Indicates increased production of red blood cells, typically seen in cases of hemolytic anemia or after acute blood loss.
• Low Reticulocyte Count: Suggests inadequate production of red blood cells, which may be seen in aplastic anemia, iron deficiency anemia, or chronic disease.
• Normal Reticulocyte Count: Can suggest that anemia is due to an underlying chronic process or that the marrow is not responding adequately.